What To Look For In Home Health Employers As A New Grad

If you’ve read either of my previous articles, you know that I’m passionate about home health. In my first, I discussed reasons why a new grad would benefit from a home health experience. In the second, I provided an overview of methods of gaining experience in home health. I think it’s an amazing field that would benefit so much from the spirit and skill sets of new grads, but because of its uniqueness compared to other areas of PT, I also think it’s paramount that new grads are cautious to select organizations that are equipped to provide them the most rewarding experience.

Why do I think it’s so important to take extra caution when selecting an employer in home health? There are many reasons, but the two that immediately come to my mind are:

1. You’re going into someone’s home. You have no idea what you’ll be walking into.
2. You’re alone. Although your team is a call or click away and at times you can justify co-treating, you’re primarily alone in someone’s home. Granted, critical thinking is necessary in every area of PT, but it’s an entirely different ball game when you’re in home health.

You may wonder why I’d start off an article focused on drawing new grads to home health by describing some of the most intimidating things about this profession. The answer: they were also my two favorite things!

Going into a vastly unique environment with every new patient was part of the adventure and challenge of it all. And autonomy and the ability to actually have undivided one-on-one time with a patient is awesome! But the main component that turns the intimidating facets of home health into adventures and making it, what I consider to be one of the most rewarding areas of practice around, is having adequate training and mentorship.

Qualities to look for in potential home health employers

As a new graduate, one of the first things I would look for in a home health agency is their experience with non-seasoned clinicians.

• Do they have a solid student program? This may provide insight on if they have clinical instructors/educators that are familiar with working with less experienced clinicians. Some examples of things to look for in an agency’s student program can be found on the Home Health Section’s (HHS) website.
• Do they have a formal mentorship program in place? There can be many levels of a mentorship or buddy program, but from my experience, the more formalized, the better. You want to ensure there is a clinical team member that is a good communicator, a skilled educator, a star performer, and a company champion that will be allowed ample time to give you the support you need to ensure you have the best experience possible. A sample of what to look for in a mentorship program can be found on the HHS website as well.

Next, I would want to know about the organization’s dedication to hiring clinicians skilled in and/or pursuing higher level training in the nuances of home health.

• Do they have any clinicians that have received, are pursuing, or have taken courses from the Certificate of Advanced Competence in Home Health? Keep in mind with this question that this is a newer program, so not all agencies may be aware that it is out there, but it would be interesting to find out which organizations are in touch with the latest and greatest programs developed by their section. There are many nuances to home health that, despite having years under your belt in another area of PT, can only be learned through time spent actually working in or seeking out coursework specifically dedicated to this field.
• Does their Staff Development/Preceptor/Field Trainer, etc team have clinicians who are OASIS (Outcome and Assessment Information Set) certified? The OASIS is home health tool to assess patient outcomes. Some clinicians view it as a lot of paperwork, but I thought of it as a window into my patient’s whole self. There are questions I never would have thought to ask or fully comprehended the relevance of in developing my PT treatment plan if it wasn’t for having to complete the OASIS. I saw it as a tool for assisting me with identifying what other home health resources my patient may benefit from.
  • While asking about feeding, I may find out someone has trouble swallowing, so they don’t take their large pills consistently.
  • While inquiring about how often they feel down or lack pleasure in doing things, I may realize that someone that has been deemed ‘non-compliant’ may be struggling with feelings of depression.

Sure, it’s a data set to measure home health outcomes, and I won’t lie and tell you that it’s not time intensive, but as a ‘green’ home health PT, I always appreciated it as a tool to help me see aspects of my patient that I otherwise may not have. And that appreciation only came from a mentor that was well-trained in it and understood the deeper benefits of it.

• Does the organization have clinical/specialty ladders in place? This could be in wheelchair assessment, lymphedema management, wound care, mental health, etc. This question shows not only if the company is dedicated to their clinicians’ growth and development, but also helps you identify what types of specialty resources will be available to you.

Questions to ask potential home health employers

Once you research home health agencies, land on a few places you’re interested in, and receive offers for interviews, you’ll want to prepare questions for the interviewer to help determine if the organization is a good fit for you. This certainly isn’t an exhaustive list, but there are definitely questions that over the years I’ve added to my bag of tricks and/or wish I had added to my bag of tricks.

• Have they hired new grads in the past? Do they have experience handling the extra time/resources that may be necessary during new grad onboarding.
• Does/how does orientation or onboarding differ for a new grad versus a more experienced clinician? I’d be concerned if as a new grad, especially one without any home health experience, I went through an identical orientation as someone with 12yrs of experience as a home health PT
• What is the ratio of mentors/preceptors to new hires? Will you have the same preceptor throughout your orientation or will you work with multiple preceptors? Will your preceptor also have other new hires to orient at the same time?
• What are the productivity standards for new hires? And what is the ramp up time allotted to achieve full productivity? There’s no gold standard here. If I was a student with an organization and am now looking to get hired by them, I may be ready to ramp up faster than someone with no experience at that organization. Or if you’re already familiar with the documentation system from a previous experience, your ramp up time may not be as time intensive as if you’re learning a brand new system. You just want to make sure that you’re comfortable with what’s presented to you and that you know and understand your expectations up front.
• After orientation/onboarding is complete, does the organization offer any sort of mentor/buddy program for future support? Although you’ll most likely meet a lot of new team members during orientation, it is nice to know if there will be a specific point person to reach out to if you’re in a pinch.
• Does onboarding/orientation include shadowing other members of the interdisciplinary team? I can’t stress the importance of gaining full understanding of what your teammates do and when it’s appropriate and necessary to request referrals for their services.

In Closing …

I’ve heard stories of passionate, bright-eyed clinicians that had their dreams squashed by negative orientation experiences. And I’ve seen lukewarm clinicians be completely inspired and transformed into awesome home health champions because of their onboarding experiences. I was the ‘green’ orientee, then a field preceptor, and eventually a staff development specialist. I grew to love home health, not despite the challenges of it, but because of them. But it didn’t happen overnight and I didn’t develop that passion alone. I’m sure this is true of many areas of practice, but definitely fitting for home health is the saying that ‘It takes a village’.

If you’re inspired to seek out a job in home health, I can’t stress enough the importance of not only preparing for how you’ll answer questions during an interview, but also preparing questions you’ll use to interview potential employers. It’s so important to select the right organization that fits with your level of experience and comfort in this setting. Since it truly does take a village, you need to make sure you find the right tribe!

Best of luck in all your adventures!

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